Older People & Long-Term Care Policy Division

Steve Milson

Deputy Director

Older People & Long-Term Care Policy Division

Welsh Assembly Government

CathaysPark

Cardiff CF10 3NQ

Dear Mr Milson

Consultation: Social Services Directions Paper

Please accept this correspondence as a formal contribution to the current consultation exercise relating to Fulfilled Lives: Supportive Communities. It is submitted on behalf of the Welsh Assembly Government’s Mental Health Implementation Advisory Group (IAG).

As you may be aware, the IAG has been established on the instructions of the Minister for Health and Social Services. Its role is to provide advice and guidance on the implementation of the National Service Framework (NSF) for Mental Health Services in Wales for adults of working age. The NSF is the overarching framework to be used by our mental healthcare stakeholders, as we work together to raise the standard of our mental health services over the coming years. The IAG comprises a wide range of representatives drawn from various stakeholder groups. These include: the NHS, Local Authorities, key professional groups, the voluntary sector, service users and carers.

This response to your consultation has been informed by a formal discussion about Fulfilled Lives: Supportive Communities that was held at the last quarterly meeting of the IAG. It represents a consensus view that emerged during that discussion. I am able to confirm that the Group is happy for its views (as reflected in this letter) to be published.

To begin, the IAG is pleased that a document such as Fulfilled Lives: Supportive Communities has been drafted. There has been some concern among the membership of the IAG that Designed for Life is limited by the fact that it focuses on healthcare, and that it fails to emphasise the important inter-relationship between health and social care. It is clearly very important that a companion document to Designed for Life (that provides a sense of strategic direction for social care) is issued by the Welsh Assembly Government. Whereas it would have been better to have published an integrated health and social care document, two complimentary strategic documents will suffice.

The IAG is firmly of the opinion that there is much in the draft version of Fulfilled Lives: Supportive Communities that is to be commended. The group is particularly pleased about the attention and emphasis that is given in the document to the key issues of: (a) empowering service users, (b) early intervention (c) the priority given to the need to sustain people in their own homes.

However, we have some concerns about the proposed strategy. These are summarised in the following points:

(i)The mental health agenda is not accorded sufficient recognition or priority in Fulfilled Lives: Supportive Communities (neither is it in Designed for Life). The Welsh Assembly Government has agreed that mental health is one of its priorities and so should give emphasis to it within key health and social care policy initiatives.

(ii)In general there are few references to adult mental health, despite the fact that references are frequently made to other client-specific matters.

(iii)It is concerning that the document makes no reference to Raising the Standard, the National Service Framework for Mental Health Services for Working Age Adults. This is in contrast to the fact that it makes specific reference to both the Childrens’and Older Peoples’ NSFs. Mental Health is also a WAG priority, and should be mentioned as such in Fulfilled Lives: Supportive Communities. .

(iv)It is reassuring that Fulfilled Lives: Supportive Communities emphasises the importance of social care workforce modernisation. However, not enough emphasis is made of the need to integrate the health and social care workforce development agendas (particularly in relation to mental health services). Workforce modernisation that transcends traditional organisational boundaries must be a given in the future.

(v)It is imperative that the development of the final version of Fulfilled Lives: Supportive Communities “joins up” with the current review of structures for commissioning and delivery of mental health services in Wales. This review was established by Ann Lloyd and is jointly chaired by Hilary Pepler (Chief Executive North East Wales NHS Trust) and Stewart Greenwell (Director of Social Services for Torfaen and lead director for mental health on behalf of ADSS). These major pieces of work must compliment each other.

(vi)The final version of Fulfilled Lives: Supportive Communities must also been seen to be clearly “joined up” with the Commissioning Framework for NHS Wales. This is a general point, but one which especially affects mental health.

(vii)The Strategy should address the impact on the mental health of our population of such key issues as housing, education, and other local government functions/departments.

(viii)We urge very strongly that a detailed paper that specifically tackles mental health issues be one of the ‘supplementary papers’ proposed in Fulfilled Lives: Supportive Communities.

We trust that these comments helpfully inform the next stage of the project to develop this very important strategic document. Should you require further support or input to this work, the IAG would be happy to oblige.

On behalf of the Mental Health Strategy IAG

Yours sincerely

Jeff Williams Bill Walden-Jones

Joint Chair of the IAG Joint Chair of the IAG